Chronic Total Occlusions: Causes and Treatments

Chronic Total Occlusions

The human body is fueled by blood.  The heart’s intricate system of chambers, valves, and arteries coordinates to provide each part of the body with a sufficient amount of oxygen-rich blood, adjusting rhythm, rate, and pressure as needed.  At the same time, the heart is supplying itself with blood to feed the myocardium, or heart muscle, through the coronary arteries.  However, when a blockage occurs within one of these arteries, there can be devastating results.

What are Chronic Total Occlusions?

Just like other arteries throughout the body, coronary arteries are susceptible to atherosclerosis, a build-up of plaque that can cause narrowing.  When this occurs, it is known as coronary artery disease and can lead to problems such as chest pain, arrhythmia, or even heart attack. 

As the coronary arteries narrow, they may eventually develop a complete blockage.  This is known as a total coronary occlusion.  However, because the blockage has built up over time, the heart has had time to accommodate by developing collateral blood vessels to bypass the area.  For this reason, total occlusions have the potential to last for a while.  When one has been present for at least three months, it is classified as a chronic total occlusion (CTO).

How do Chronic Total Occlusions Develop?

Coronary artery disease, which can lead to total occlusions, develops when there is damage to the lining of the arteries.  These damaged areas allow fatty deposits to collect and build up gradually.  As they do, the artery becomes narrower, and blood flow becomes more restricted, until a complete blockage has occurred.  The potential causes of the initial arterial damage are many.  Among the more common are smoking, high cholesterol, high blood pressure, and diabetes. 

How are Chronic Total Occlusions Treated?

There are several possibilities for treatment of CTO and determining which is best will depend on the individual patient.  Among the many options are:

  • Coronary Artery Bypass Grafting (CABG) – Historically, most cases of CTO have been treated with bypass surgery in which an artery or vein from another area of the body is used to create a detour for blood to flow around the blocked artery.
  • Angioplasty & Stenting– During an angioplasty, a balloon is inserted into the coronary artery and inflated to widen it and improve blood flow. In most cases, a stent is also placed in order to keep the artery open and supported. 
  • AtherectomyAtherectomy is a procedure used to clear plaque. It uses a catheter outfitted with a small, rotating blade or laser to remove the buildup from the artery.
  • Medication – Prescription medications may be used to help control the symptoms associated with CTO.

If the condition is too severe for traditional percutaneous coronary intervention (PCI), or if the patient is at high-risk for surgery complications, protected PCI may be an option as well. To learn more about protected PCI, contact 337-988-1585.

Coronary occlusions are dangerous and can even be deadly.  If you are suffering from symptoms of a heart condition such as chest pain, it is important to seek medical attention immediately.  The earlier a problem can be detected and treated, the better your outcome will be.  To schedule an appointment with a cardiologist, contact any location of Cardiovascular Institute of the South, or click the button below.

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CIS Staff

Written by CIS Staff